Beyond wellness: Helping your employees on their journey to well-being

June 11, 2018

Self-funded

Health and Wellness

For years, health insurers and employers have sought to engage members in their own health through wellness programs that encourage physical activity, weight loss, lower stress, smoking cessation and other healthy behaviors.

While comprehensive wellness programs have shown to be successful, a more recent trend goes a step beyond wellness, taking a broader, more holistic approach to helping members navigate their health care journey. This is in response to employee pleas for help with a host of tasks ranging from choosing a health plan to finding and paying for quality, cost-effective care, and even addressing emotional and mental health issues. Employers welcome this broader offering as an advantage both to recruiting in a tight market and to retention and productivity.

“Too often, wellness programs are viewed as an add-on program that is not really integrated into the overall human capital strategy,” says Seth Serxner, PhD, Chief Health Officer, Optum. “In addition, there is recognition of the need to address the mental and emotional well-being of employees and families.”

Employers are shifting from wellness to well-being

The shift toward well-being still encompasses physical wellness but adds emotional, social and financial well-being as well.[1] [2] These new programs seek to enhance the user’s immediate experience and happiness – and ultimately longevity -- either through high-touch advocacy programs or online through mobile apps. Incentives in such programs shift from an individual, financial focus to group-oriented philanthropic model; for example, if a group of employees hits a targeted level of diagnostic screening, a donation is made to a charitable organization.

Members often find health insurance options confusing and are unsure how to respond to a health incident or concern. The resulting delays can worsen their problem and increase the cost to treat it.[3] [4] [5] In fact, a third of individuals say they have found the health system so complex and confusing they simply give up and “hope for the best.”[6] Although rising health care costs, including larger deductibles, higher coinsurance and copays, have created a more engaged health care consumer, they also have led to unintended consequences: One in five people say that high out-of-pocket costs prompted them to decline coverage, stop taking medications or avoid care altogether, according to a recent survey.[7]

Employers are responding in an integrated way with “well-being” features that proactively address complex, chronic and costly health conditions that diminish and curtail quality of life – especially those conditions with a range of treatment options across multiple sites of care with widely variable outcomes. For instance, the rate of employers offering programs directing employees to select clinics for treating back and joint pain increased from 8 percent in 2015 to 31 percent in 2017.[8]

Advocates can help members navigate the health care process

In addition, employers want to offer services to help simplify the health care experience for members by improving navigation and accessibility. One such service, health advocacy, offers one point of contact to members to help them navigate the system and provide information to help them make more informed decisions about treatment and place of care. Advocacy services have risen from 24 percent of employers in 2015 to 38 percent in 2017.[9]

UnitedHealthcare’s trained advocates provide members with benefit information, answer their questions, provide information on care options to consider, and suggest services and programs to help meet their needs. Advocates may proactively call members who seek out-of-network care that will likely significantly increase their out of pocket costs, helping them find a quality, UnitedHealth Premium® designated network provider. Members appreciate this service, as shown by the program’s Net Promoter Score® (NPS®) of nearly +80, said Jeremy Selko, Senior Director Product and Innovation, UnitedHealthcare (NPS measures customer loyalty with “-100” meaning everyone is a detractor and “+100” meaning everyone is a promoter).

“We reach people before they even know they need us,” Selko says.

UnitedHealthcare’s Advocate4Me® program directs members with complex, costly disease to an appropriately skilled advocate who can help them navigate the health care system and answer their questions about a wide variety of topics from finances, benefits and claims to wellness, emotional health, and complex health care support. The individual’s demographics and claims history can help the advocate anticipate what the individual may need, Selko said.

UnitedHealthcare also offers advocates in specialties, such as behavioral health and pharmacy. Behavioral health care advocates provide information on care options and link members with community resources, while pharmacy advocates have led to a 20 point increase in NPS as well as better outcomes and member resolution.

Digital tools to help improve the member experience

In addition to providing advice from trained agents, new digital health care tools are being developed to aim to improve the consumer’s experience.[10] Members, especially millennials, expect health care tools to be available on their smartphones.

Rally®, Optum’s consumer digital health platform, has leveraged the latest technology to simplify the health care experience for members and help them make better-informed decisions about their care. For example, Rally’s physician-search and cost-estimator tool, which launched a mobile version last year, has been used by more than 35 million people to conduct 32.7 million search sessions. Rally has boosted the use of transparency tools among members, which in turn has increased the shift from out-of-network to network providers by 33 percent and the switch from emergency room care to urgent care by 77 percent. The result is lower costs for both the employee and the employer, says Doreen Bortel, Senior Vice President of Sales for Optum’s Population Health Solutions.

Wearable devices are already a popular part of many wellness programs such as UnitedHealthcare Motion®, in which members may earn more than $1,000 per year by meeting certain daily walking goals. Employers increasingly use new apps for wearables to further engage employees in their health and well-being through game-like features and online competitions and challenges.[11]

The power of immediacy

While wellness programs succeed at sustaining longer-term health goals, well-being initiatives quickly respond to the needs of consumers and employers, yielding significant benefits both long-term and here and now.

The UnitedHealth Premium® designation program is a resource for informational purposes only. Designations are displayed in UnitedHealthcare online physician directories at myuhc.com®. You should always visit myuhc.com for the most current information. Premium designations are a guide to choosing a physician and may be used as one of many factors you consider when choosing a physician. If you already have a physician, you may also wish to confer with him or her for advice on selecting other physicians. You should also discuss designations with a physician before choosing him or her. Physician evaluations have a risk of error and should not be the sole basis for selecting a physician. Please visit myuhc.com for detailed program information and methodologies.

Advocate4Me services should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through Advocate services is for informational purposes only and provided as part of your health plan. Wellness nurses, coaches and other representatives cannot diagnose problems or recommend treatment and are not a substitute for your doctor’s care. Your health information is kept confidential in accordance with the law. Advocate services are not an insurance program and may be discontinued at any time.

Rally Health provides health and well-being information and support as part of your health plan. It does not provide medical advice or other health services, and is not a substitute for your doctor's care. If you have specific health care needs, consult an appropriate health care professional. Participation in the health survey is voluntary. Your responses will be kept confidential in accordance with the law and will only be used to provide health and wellness recommendations or conduct other plan activities.

UnitedHealthcare Motion is a voluntary program. The information provided under this program is for general informational purposes only and is not intended to be nor should be construed as medical advice. You should consult an appropriate health care professional before beginning any exercise program and/or to determine what may be right for you. Receiving an activity tracker and/or certain credits may have tax implications. You should consult an appropriate tax professional to determine if you have any tax obligations from receiving an activity tracker and/or certain credits under this program, as applicable. If any fraudulent activity is detected (e.g., misrepresented physical activity), you may be suspended and/or terminated from the program. If you are unable to meet a standard related to health factor to receive a reward under this program, you might qualify for an opportunity to receive the reward by different means. Contact us and we will work with you (and, if necessary, your doctor) to find another way for you to earn the same reward. Rewards may be limited due to incentive limits under applicable law.

[2] The Underestimated Cost of the Opioid Crisis. The Council of Economic Advisors. November 2017. Accessed at https://www.whitehouse.gov/briefings-statements/cea-report-underestimated-cost-opioid-crisis/.